The impact of mean first‐year heart rate on outcomes after heart transplantation: does it make a difference?. (8th August 2013)

• Record Type: Journal Article
• Authors: Shah, Ankit B.; Patel, Jignesh K.; Rafiei, Matthew; Morrissey, Ryan P.; Kittleson, Michelle M.; Kobashigawa, Jon A.
• Is Part Of: Clinical transplantation. Volume 27:Number 5(2013:Sep./Oct.)
• Page Start: 659
• Page End: 665
• Publication Date: 2013-08-08
• Subjects: Transplantation of organs, tissues, etc -- Periodicals; 617.95
• DOI: 10.1111/ctr.12188
• Languages: English
• ISSNs: 0902-0063

Abstract

<abstract abstract-type="main" id="ctr12188-abs-0001"> <title>Abstract</title> <sec id="ctr12188-sec-0001" sec-type="section"> <title>Background</title> <p>Cardiac denervation following transplantation has a variable effect on heart rate (HR), and the consequence of this is not known. We examined the impact of first‐year HR on five‐yr outcomes after heart transplant.</p> </sec> <sec id="ctr12188-sec-0002" sec-type="section"> <title>Methods</title> <p>We evaluated 544 heart transplant recipients from 1994 to 2008. Patients were divided into groups by mean first‐year HR: group 1, HR < 90 (mean 85.0 ± 4.3); group 2, 90 ≤ HR < 110 (mean 97.8 ± 4.9); group 3, HR ≥ 110 (mean 111.5 ± 1.8). Endpoints included one‐yr freedom from treated rejection, five‐yr survival, five‐yr freedom from cardiac allograft vasculopathy (CAV), and five‐yr freedom from non‐fatal major adverse cardiac events (NF‐MACE).</p> </sec> <sec id="ctr12188-sec-0003" sec-type="section"> <title>Results</title> <p>One‐yr freedom from treated rejection, five‐yr survival and freedom from CAV were not significantly different between groups. Five‐yr freedom from NF‐MACE was significantly lower in group 3 compared with group 2, 69% vs. 91%, p < 0.01, mainly due to higher prevalence of congestive heart failure (CHF) in group 3 over five yr.</p> </sec> <sec id="ctr12188-sec-0004" sec-type="section"> <title>Conclusions</title> <p>Mean first‐year HR does not provide prognostic significance for one‐yr freedom from treated rejection, five‐yr survival or development of CAV five yr after heart transplant. These results suggest that HR post‐heart transplantation does not affect long‐term outcomes, but high first‐year HRs may be associated with new‐onset CHF.</p> </sec> </abstract>